The Acceptability of a Recovery Group Intervention in Acute Inpatient Mental Health Wards

Abstract

limited in acute inpatient settings (MIND, 2011) and there are inherent challenges in implementing such interventions. The acute inpatient setting poses multiple challenges, including a high level of distress and acuity of mental health, as well as short admissions, which limit the amount of time available to complete psychological interventions (Donaghay-Spire et al., 2016). A proportion of patients are also detained under the Mental Health Act, and may feel disempowered, experiencing treatment as coercive as a result (Seed et al., 2016).With attention paid to psychological group therapy specifically in such environments, Clarke and Wilson ( 2009) noted challenges including the potential 'dilution of therapy'; with the practicalities involved in organising group sessions and short admissions leading to incomplete group attendance. They also note that inpatient group therapy affords the opportunity for multi-disciplinary team working and the dissemination of psychological knowledge throughout the hospital system.Research focusing on psychological group therapy in acute mental health inpatient settings is limited. However, studies have shown that psychological therapy provided on an acute ward is valued by both staff and service users

Patient perspectives on psychological interventions provided in adult psychiatric inpatient wards: A thematic synthesis

“…4.1 | Shared experience: 'It is good to know I'm not alone' (Pownell et al, 2023) Participants who had engaged with group interventions across nine studies spoke of the importance of a shared, collaborative experience with other participants where they felt supported during group therapy. Hearing other people disclose lived experiences related to their mental health was beneficial for participants to know that they were not alone in their difficulties and gave some people more confidence to share their own experiences.…”

“…Participants valued hearing from experts by experience (Pownell et al, 2023) or peers at a different point in their journey as it gave them hope for their future. Overall rating…”

“…'Sometimes the class was in a little bit of chaos and I felt irritable towards the group members who were speaking loudly and dominating the group' (Chen et al, 2018) '[Ask facilitators to] silence annoying patients who disrupt the group, they ruin the whole emphasis of the message that the psychologist is trying to get across' (Pownell et al, 2023) Groups did not always feel safe for some participants (Fife et al, 2019), and speaking about difficult experiences in front of others could be anxiety-provoking (Visagie et al, 2020). Some participants commented on groups feeling uncomfortable when peers did not contribute (Harris et al, 2021;Radcliffe & Bird, 2016) or were explicitly disrespectful, for example, laughing inappropriately (Chen et al, 2018).…”

“…Because if it's going to be the same group dynamic it will just keep continuing to happen. And rather than putting myself in that situation, then getting frustrated and having to leave, to not go in the first place' (Harris et al, 2021) In addition to difficulties with the behaviour of peers, participants in two studies reflected on wanting facilitators to do more in terms of managing group dynamics (Chen et al, 2018;Pownell et al, 2023).…”

“…were rude sometimes when asking them for help or telling them I'm not feeling well. I was afraid of telling them"' (Visagie et al, 2020) 'Some commented that they found the delivery of the sessions to be a challenge: "Please respect that it may come over patronising"' (Pownell et al, 2023)…”